Neurocardiogenic syncope and atrial Fib?

When I first got my pacemaker 3 years ago, I came here and received wonderful support! Everyone here calmed my fears and I finally got over my anxiety of having one and have accepted my new pacemaker way of life. I had my implanted because of neurocardiogenic syncope. I have the Medtronic MRI safe model. At most of my check ups, my pacemaker was kicking in 15 % of the time. Now at my last check up, they say I might have atrial fib. My heart has been racing more than normal and I also experience little pains in my heart in 2 places, mostly after I eat. I am freaking out once again! I am having some tests done this week- lab work, and EKG, and echo and a 24 hour Holter monitor. If I have atrial fib, will I need a new pacemaker? Or can they make adjustments? What else could this be? I look forward to hearing from you!

2 Comments

Fib shmib

by Theknotguy - 2014-03-02 05:03:12

Atrial fib is no fun. I've had it all my life but was officially diagnosed nine years ago. The problem with a-fib is that it can cause a blood clot in your heart. Then when the heart returns to a normal beat it pumps out the clot and you have a stroke, heart attack, etc. Please note, I said "can" - I've had a-fib for years and haven't had any clots pumped out. In most cases I don't even get a blood clot.

There are three kinds of a-fib for me. One kind for me is what I call "benign". It's uncomfortable, makes me short of breath, prevents me from doing any kind of exercise, and lasts about 24 hours. I've worked it out with my cardiologist. I'm to take extra medication, rest in a recliner, and generally wait it out.

The second kind is where my heart starts racing. (A-fib with RVR) My heart rate will take off, keep going faster and faster, it will eventually go so fast it will kill me. I can tell when it happens and know to immediately call 911 and get to a hospital as fast as I can. They usually give me a cardizem drip and slow my heart rate to normal.

The third kind... Well, it killed me. Went down on the trail. My heart beat was 20 when they got to me, then it stopped in the ambulance. I now have the PM to take care of this.

Based upon your PM model you may have the one that has APP (Atrial Preference Pacing). It's a software program that tries to mitigate or stop a-fib. They recently turned on APP with my PM. It feels funny when it kicks off but over the past few weeks it seems to have mitigated my a-fib. After a lifetime of a-fib I'm very happy to have it.

If your PM doesn't have the a-fib control software they may be able to download it into the PM. So, even though you may not have it now, you still might be able to get it. To turn on APP, it's just a few taps of the stylus while they're doing a PM checkup.

Outside of the PM there are medications to control a-fib. For a-fib there is rhythm control and rate control. They tried rhythm on me but it didn't work. So I'm not very educated as to how it works.

Rate control is where they can't stop the a-fib. So they slow down the heart to keep the heart from racing away.
I'm on Cardizem and Metoprolol to slow down my heart. Oh, and they want you to take a blood thinner to prevent clots. But if you have a PM you're on blood thinners anyway.

Prior to the PM they had to worry about slowing down my heart to where it would stop. With rate control and the PM they can slow down the heart to below what would keep me alive and then use the PM to keep it beating at a normal rate. This stops the heart from racing and gives it time to "convert" - i.e. go back to a normal heart rate. They can also convert your heart using electro-conversion.

Some people don't know they have a-fib. I can tell when it starts, what kind, and when it stops. Most people get short of breath and feel their heart racing when they're in a-fib.

A-fib is serious. But they have a lot of medication to keep it under control. The jury is still out on pacemakers using APP. My EP said they don't know if it works but it won't hurt to have it turned on. Personally I feel it's "trained" my heart to stop a-fib, but I doubt the doctors would agree.

The worst thing you can do is to get all excited and start talking yourself into a-fib sessions. Over time your heart "learns" how to go into a-fib. Having medications and a PM to mitigate a-fib will help slow down its progression and your discomfort. So try not to work yourself up into a tizzy over a-fib.

As I tell the medical people working on me, "If you had an a-fib session, you'd be in the hospital." When I get a-fib it's, "Cuss an swear, another a-fib session!!" I do take it seriously - it's just that I've had it so much I don't get excited about it anymore. Usually I'm annoyed.

You can lead a fairly normal life with a-fib. I hope they can get your a-fib under control quickly and you can go on about your life. I wish the best for you.

Theknotguy

A-Fib

by Roys - 2014-03-02 09:03:35

Hi
If you want info on A-fib google A-fib.com by Steve Ryan.
There is only one cure for AF and that is an PVI (ablation).
Also you don't need a blood thinners for just having a PM.
Roy

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